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Table 1 Interventions to increase breastfeeding in obese mothers

From: Reduced breastfeeding rates among obese mothers: a review of contributing factors, clinical considerations and future directions

Authors, year of publication, country Study population Intervention Control Breastfeeding outcomes Child health outcomes
Rasmussen et al. 2011 [88] Rural New York, USA (BIBS1) BMI > 29 carrying singleton infants recruited at ≤ 35 weeks gestation, delivering at ≥ 37 wks gestation in Rural Bassett Hospital 3 telephone calls by one of 3 IBCLCs. One call prenatally and then at 48 and 72 h to educate, assist with and encourage breastfeeding. 1 prenatal telephone call (less detailed) EBF median: support 3.4wks (25th–75th % 0.7–8.4) control 8.1wks (2.1–13.1) Not assessed
Any BF median: support 8.6wks (3.9–13.0), control 12.6wks (9.1–13.5)
n = 40
Rasmussen et al. 2011 [88] Rural New York, USA (BIBS2) BMI > 29 carrying singleton infants recruited at ≥ 35 weeks gestation, delivering at ≥ 37 wks gestation in Rural Bassett Hospital Mothers given manual or multiuser electric breastpump and instructed to pump for 10 min after each of 5 breastfeeding sessions each 24 h for 5 days or until their milk came in. Usual care. No breastpump or instructions given EBF median: manual pump 2.3wks (0.4–4.4), electric pump 0.7wks (0.1–2.7), control 4.4wks (1.1–9.4) Not assessed
Any BF median: manual pump 13.4wks (2.1–36.0), electric pump 4wks (2.4–8.4), control 26.6wks (9.4–44.6) p < 0.004 for pumping groups
n = 39
Chapman et al. 2013 [89] Connecticut, USA BMI ≥ 27 carrying singleton infants recruited at ≤ 36 weeks gestation, from prenatal Baby Friendly Hospital clinic, income < 185 % of the federal poverty level with telephone access. Infants ≥ 36 weeks’ gestation, birth weight ≥2.5 kg and ≤ 3.9 kg, 1 and 5 min Apgar scores of ≥ 6, and no NICU admission. 3 prenatal visits, daily in-hospital support, phone access, up to 11 postpartum home visits from specialized obesity-trained breastfeeding peer counselors. Home visits tentatively scheduled 3 per week in 1st week, 2 per week in weeks 2–4, 1 per week in weeks 5 and 6. Phone call between 2 and 3 months. Large breastfeeding sling, single electric breastpump if separated for work/school. Mothers had work phone number of peer counselors. 3 prenatal visits, daily in hospital support and up to 7 home visits from Breastfeeding Heritage peer counselors. Mothers had work phone number of peer counselors. Any BF at 2 weeks: AOR 3.76 (95 % CI: 1.07, 13.22) Odds of hospitalization in first 6 months after birth: AOR 0.24 (95 % CI: 0.07, 0.86)
≥50 % of feedings as breast milk at 2 weeks: AOR 4.47 (95 % CI: 1.38, 14.5)
N = 206
Carlsen et al. 2013 [90] Denmark BMI ≥ 30 delivering healthy singleton infants at term participating in prenatal weight gain reduction (TOPS) study in Denmark recruited at < 48 h postpartum Minimum of 9 telephone consultations by a single IBCLC if continuing to breastfeed. First call in first week postpartum, 2 more calls in first month, every 2 weeks until 8 weeks, and monthly until 6 months. Extra calls for specific difficulties, mothers had study IBCLC phone number Usual care, including contact with a breastfeeding supportive pediatric nurse within 1 week of birth, and standard breastfeeding support at study hospital EBF median: Support 120d (14-142d) Days of exclusive breastfeeding inversely associated with:
Control 41d (3-133d) p = 0.003 Infant weight at 6 months
Any BF median: Support 184d (92–185d) Control 108d (16–185d) p = 0.002 β = 4.39 g/day, (95 % CI: −0.66, −8.11 p = 0.021)
n = 207
EBF 3 months: AOR 2.45 (95 % CI: 1.36, 4.41 p = 0.003) Infant length at 6 months
Any BF 6 months: AOR 2.25 (95 % CI: 1.24, 4.08 p = 0.008) β = 0.012 cm/day (95 % CI: −0.004, 0.02 p = 0.004)
  1. BF breastfeeding, EBF exclusive breastfeeding, AOR adjusted odds ratio, CI confidence interval